caa a22 4500 606157816 CHVBK 20210128100615.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10096-014-2241-5 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2241-5 Prevalence of blaZ gene types and the cefazolin inoculum effect among methicillin-susceptible Staphylococcus aureus blood isolates and their association with multilocus sequence types and clinical outcome [Elektronische Daten] [Y. Chong, S.‐J. Park, E. Kim, K.-M. Bang, M.-N. Kim, S.-H. Kim, S.-O. Lee, S.-H. Choi, J.-Y. Jeong, J. Woo, Y. Kim] Cefazolin treatment failures have been described for bacteraemia caused by methicillin-susceptible Staphylococcus aureus (MSSA) with type A β-lactamase and inoculum effect (InE). We investigated the prevalence of blaZ (β-lactamase) gene types and a cefazolin InE among MSSA blood isolates in South Korea and evaluated their association with specific genotypes. The clinical impact of the cefazolin InE was also evaluated. A total of 220 MSSA isolates were collected from a prospective cohort study of S. aureus bacteraemia. A pronounced InE with cefazolin was defined as a ≥4-fold increase in the minimum inhibitory concentration (MIC) between a standard and high inoculum, resulting in a non-susceptible MIC. Sequencing of blaZ and multilocus sequence typing (MLST) were performed. Clinical outcomes were assessed in 77 patients treated with cefazolin. The blaZ gene was detected in 92% of the 220 MSSA isolates. Type C β-lactamase was the most common (53%), followed by type B (20%) and type A (17%). Certain genotypes were significantly associated with specific β-lactamase types (notably, ST30 and type A β-lactamase). A pronounced cefazolin InE was observed in 13% of isolates. Most of these (79%) expressed type A β-lactamase and ST30 was the predominant (55%) clone amongst them. Cefazolin treatment failure was not observed in patients infected with strains exhibiting a pronounced InE. These strains had no impact on other clinical outcomes. In conclusion, the prevalence of a pronounced InE with cefazolin could be dependent upon distributions of MSSA genotypes. Cefazolin can likely be used for the treatment of MSSA bacteraemia (except endocarditis), without consideration of an InE. Springer-Verlag Berlin Heidelberg, 2014 Chong Y. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Park S.‐J Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Kim E. Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Bang K.-M Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Kim M.-N Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Kim S.-H Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Lee S.-O Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Choi S.-H Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Jeong J.-Y Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Woo J. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Kim Y. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 349-355 0934-9723 34:2<349 2015 34 10096 https://doi.org/10.1007/s10096-014-2241-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2241-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chong Y. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Park S.‐J Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim E. Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Bang K.-M Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim M.-N Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim S.-H Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Lee S.-O Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Choi S.-H Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Jeong J.-Y Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Woo J. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Y. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 349-355 0934-9723 34:2<349 2015 34 10096